CD4 and neoplasm: Several studies have reported that lymph node gross tumor volume (GTVln), gross tumor volume of the nasopharynx (GTVnx), circulating CD4 T lymphocytes, lactate dehydrogenase, lactate dehydrogenase (LDH) level before treatment, hemoglobin level, and EBV DNA level were significantly associated with the distant metastases of NPC (6, 39, 40).